Hotline No:

MbcÖRvZš¿x evsjv‡`k miKvi

¯^v¯’¨ Awa`ßi, gnvLvjx, XvKv-1212

‡KvwfW- 19 bgybv msMÖn I cixÿv (RT-PCR)
dig

Specimen ID: Date specimen collected _____/_______2020

bvg (Bs‡iwR eo nv‡Zi Aÿ‡i)

‡mev MÖnxZvg c~iY Ki‡eb:

*:
‡gvevBj bs-*: †gvevBj gvwj‡Ki wbR ¯^vgx/¯¿x mšÍvb Ab¨vb¨

mv‡_ m¤ú©K

eZ©gvb wVKvbv: BDwbqb

(evmv/‡ivW/gnjøv/MÖvg /IqvW© bs (wmwU) :

)
Dc‡Rjv/_vbv: ‡Rjv/wmwU

K‡cv©‡ikb:

Report Delivery : 12pm to 1 pm (Ward master Room) Sample Collected By

we‡kl `ªóe¨: G AskUzKz †mev MÖnxZvi cÖgvYcÎ wnmv‡e cÖ`vb Ki‡Z n‡e| Medical

Technologist (Lab)

Md. Khorshed Alam